Balloon sinuplasty (Balloon catheter dilation of paranasal sinus ostia)
A less invasive procedure that uses a small balloon to widen blocked sinus openings, for selected people with chronic sinusitis without polyps when medical treatment has not been enough.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It widens blocked sinus openings with a small balloon, without cutting away tissue or bone, for selected chronic sinusitis without polyps.
- It does not cure the underlying inflammation, and the benefit may not last for everyone — some people later need fuller sinus surgery.
- NICE judges the short-term evidence adequate with no major safety concerns when done by experienced surgeons.
- It is not a substitute for FESS when there are polyps or extensive disease; ongoing nasal treatment is usually still needed.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Widens blocked sinus openings without cutting away tissue or bone
People with nasal polyps or extensive sinus disease, who usually need fuller endoscopic sinus surgery.
Expect a blocked nose, mild facial pressure and a little blood-stained discharge. Rest with your head raised and take simple painkillers if needed. If you...
Clear advice on saline rinses and continuing steroid sprays to control inflammation.
Expect a blocked nose, mild facial pressure and a little blood-stained discharge. Rest with your head raised and...
Congestion eases and many people return to light activity and work within a few days to a week. Start saline...
Symptoms often continue to improve. Steroid nasal sprays are usually continued to control the underlying...
A follow-up appointment checks how your symptoms have responded. Ongoing sprays and rinses are continued, and your...
What is balloon sinuplasty?
Balloon sinuplasty is a less invasive way to open blocked sinus drainage channels. A thin wire and a small balloon are guided into a narrowed sinus opening, the balloon is gently inflated to stretch the opening wider, and then it is removed. Unlike traditional sinus surgery, tissue and bone are not cut away, and there is no cut on the outside of the face.
It is used for some people with chronic sinusitis whose symptoms — a blocked nose, facial pressure and a drippy nose — have not settled with steroid sprays, saline rinses and other medical treatment. It tends to suit those without nasal polyps and with disease in the more accessible sinuses, particularly the ones above the eyes.
NICE has looked at this procedure and judged that the evidence on its short-term benefit is adequate and that it raises no major safety concerns, provided it is done by surgeons with appropriate experience. It is not suitable for everyone, though — people with extensive disease or polyps usually need fuller endoscopic sinus surgery instead.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Standalone balloon sinuplasty
The balloon is used on its own to widen one or more accessible sinus openings, with no tissue removal. Best suited to limited disease without polyps.
Hybrid (balloon plus FESS)
Balloon widening of some sinus openings is combined with traditional endoscopic surgery on other sinuses where tissue removal is needed.
In-office / local-anaesthetic balloon dilation
In selected adults, the procedure can sometimes be done under local anaesthetic in a clinic setting rather than asleep in theatre.
Medical treatment (non-surgical alternative)
Not a procedure, but the main alternative: steroid nasal sprays or drops, saline rinses and treating allergy. Usually tried before any procedure and continued afterwards.
Preparing for your procedure
- See the operating surgeon, who will examine the inside of your nose with a telescope and usually arrange a CT scan to see which sinuses are affected.
- Be ready to discuss whether you have had a proper trial of steroid sprays or drops and saline rinses.
- Ask whether balloon sinuplasty really suits your sinus problem, or whether fuller surgery would be more appropriate.
- Tell your surgeon about nasal polyps, asthma, allergies and any previous sinus surgery.
- Mention all medicines and supplements, especially blood thinners, which may need managing.
- If having sedation or a general anaesthetic, arrange a lift home and someone to stay with you that night.
- Plan a few days to about a week of lighter activity.
What happens
Depending on the case, balloon sinuplasty can be done under local anaesthetic, sedation or general anaesthetic, and usually takes around 30 to 60 minutes. The surgeon passes a telescope through the nostril, then guides a thin wire and a small balloon into the narrowed sinus opening, often using X-ray (fluoroscopy) or a light at the tip to confirm the position.
The balloon is gently inflated to widen the opening, then removed. The sinus is often rinsed with saline. No tissue or bone is cut away in a balloon-only procedure, and there is no cut on the outside of the face.
Most people go home the same day. The nose may feel blocked and there can be a little blood-stained discharge for a few days. Many people recover more quickly than after traditional sinus surgery.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People with nasal polyps or extensive sinus disease, who usually need fuller endoscopic sinus surgery.
- Symptoms likely to respond to a proper trial of medical treatment first.
- Sinuses that are too narrowed, scarred or difficult to reach with a balloon.
- Expecting a cure rather than improved drainage of a long-term inflammatory condition.
Delay or rearrange if…
- You have a current heavy nasal or sinus infection.
- You have not yet had a proper trial of steroid sprays or drops and saline rinses.
- Needed scans (CT of the sinuses) have not been done.
- Blood-thinning medicines need safe management before the procedure.
- You cannot arrange a lift home and overnight support if having sedation or a general anaesthetic.
Alternatives to discuss
- Steroid nasal sprays or drops and saline rinses as first-line medical treatment.
- Treating allergy if it is contributing to the symptoms.
- Traditional endoscopic sinus surgery (FESS) for polyps or extensive disease.
- Watchful waiting if symptoms are mild and tolerable.
- A second specialist opinion on whether a balloon is the right choice.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Widens blocked sinus openings without cutting away tissue or bone
- Can improve a blocked nose and facial pressure in suitable people
- Often a quicker recovery than traditional sinus surgery
- Can sometimes be done under local anaesthetic in selected people
- May help sprays and rinses reach the sinuses more effectively
Risks & complications
- A blocked nose and mild discomfort for a few days
- Some blood-stained discharge from the nose afterwards
- Mild facial pressure or a headache that settles
- Symptoms not fully resolving, with ongoing treatment still needed
- A nosebleed needing attention
- Infection of the nose or sinuses
- The balloon not being able to open a sinus that is too narrowed or scarred
- Symptoms returning so that fuller sinus surgery is needed later
- Injury to the thin bone next to the eye, with bruising or, very rarely, double vision
- A leak of fluid from around the brain (CSF leak) from the skull base, very rarely with meningitis
- Bleeding into the eye socket affecting vision
- Risks related to sedation or a general anaesthetic if used
Balloon sinuplasty is less invasive than traditional surgery, but because the balloon still works near the eye and the base of the skull, the rare serious risks are similar in nature. The bigger practical questions are whether it suits your particular sinus problem at all — it is not for polyps or extensive disease — and whether the benefit will last. Ask your surgeon why they are recommending a balloon rather than fuller surgery or continued medical treatment.
Published figures to discuss
NICE concluded that the evidence on the short-term benefit of balloon sinuplasty is adequate and that the procedure raises no major safety concerns, while noting the evidence is mainly short to medium term and that patient selection matters. Robust long-term and like-for-like comparisons with traditional surgery are limited, so success and durability are best discussed individually. The figures below are kept qualitative where exact rates are not robust.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Short-term symptom improvement | Many suitable people improve in the short to medium term; NICE judged the short-term efficacy evidence adequate | Most evidence is short to medium term and depends on selecting the right patients (typically without polyps). | NICE — Balloon catheter dilation of paranasal sinus ostia (IPG273)nice.org.ukSource-linked context |
| Serious complications (eye or skull base) | Rare; NICE raised no major safety concerns when done by experienced surgeons | The balloon still works near the eye and skull base, so rare serious risks are similar in nature to other sinus procedures. | NICE — Balloon catheter dilation of paranasal sinus ostia (IPG273)nice.org.ukSource-linked context |
| Need for further (traditional) surgery | A proportion of people later need fuller endoscopic sinus surgery; exact rates vary by selection | Balloon dilation does not treat polyps or extensive disease, and benefit may not last for everyone. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery is often quicker than after traditional sinus surgery — many people are back to normal within a few days to about a week — though the nose can stay a little congested and ongoing nasal treatment is usually still needed.
- A blocked or stuffy nose for a few days
- A little blood-stained discharge from the nose early on
- Mild facial pressure or a headache that settles
- A gradual rather than instant improvement in symptoms
- Needing to keep using nasal sprays or rinses afterwards
Aftercare
- Start saline rinses as advised to keep the sinuses clear.
- Continue steroid nasal sprays as recommended to control inflammation.
- Do not blow your nose hard; sneeze with your mouth open in the early days.
- Avoid heavy lifting, straining, swimming and contact sports until cleared.
- Take simple painkillers if needed and avoid blood-thinning medicines unless told otherwise.
- Attend your follow-up appointment to check how symptoms have responded.
- Save the clinic's contact number in case of heavy bleeding, eye symptoms, severe headache or fever.
- Lift home and overnight support if having sedation or general anaesthetic
- A few days to about a week of lighter activity planned
- Saline rinse kit and steroid spray ready at home
- Simple painkillers collected
- Follow-up appointment noted
- Clinic out-of-hours number saved
Scars and how they heal
There is no cut on the outside of the face, so there is no visible scar. The procedure is done through the nostril and the balloon stretches the sinus opening without removing tissue.
⚠ Get urgent help if…
- Heavy or persistent nosebleed that does not settle
- Swelling, bruising or pain around the eye, or any change or double vision
- A severe headache with neck stiffness or feeling very unwell
- Clear watery fluid dripping steadily from one nostril
- A high temperature, spreading facial redness or worsening facial pain
- Sudden visual disturbance or loss of vision
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result means easier breathing and less facial pressure, with the opened sinuses draining more freely so sprays and rinses can work better. Studies and NICE's review suggest many suitable people improve in the short to medium term.
The benefit may not last for everyone, the procedure does not cure the underlying inflammation, and it is not designed for polyps or extensive disease. Some people find symptoms return and go on to need fuller endoscopic sinus surgery. Your surgeon will explain the realistic outlook for your sinuses.
How long the benefit lasts varies from person to person, and the evidence is strongest for the short to medium term. Chronic sinusitis is a long-term inflammatory condition, so symptoms can return, particularly if the underlying inflammation is not controlled. Continuing sprays and rinses helps, and some people later need traditional sinus surgery.
Related tests, treatments or support
Balloon sinuplasty is sometimes combined with traditional endoscopic surgery (a 'hybrid' approach), using the balloon for accessible sinuses and tissue removal for others. It is not usually combined with polyp removal as a balloon-only procedure, because polyps generally need fuller surgery.
Follow-up & long-term care
You will usually be seen a few weeks after the procedure to check how your symptoms have responded and to make sure you are continuing sprays and rinses. Because chronic sinusitis is long-term, ongoing review is common, and you should report returning symptoms, eye problems or persistent infection.
- Continuing steroid nasal sprays and saline rinses to control inflammation
- Treating allergy well, as it can worsen sinus symptoms
- Returning promptly if a blocked nose or facial pressure comes back
- Discussing fuller sinus surgery if symptoms return despite treatment
Repeat, follow-on and what comes next
- Symptoms can return, and some people go on to need fuller endoscopic sinus surgery.
- The balloon may not open a sinus that is heavily scarred or too narrowed.
- It does not treat polyps, which need traditional surgery.
- Good long-term control still relies on ongoing medical treatment.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear advice on saline rinses and continuing steroid sprays to control inflammation.
- A named contact route and warning signs for eye symptoms, severe headache, fluid leak or heavy bleeding.
- A follow-up appointment to check how symptoms responded.
- Honest discussion of fuller surgery if symptoms return.
- Joined-up care with allergy treatment where relevant.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The operating surgeon's fee and how many sinuses are treated
- The type of anaesthetic — local, sedation or general — and any anaesthetist's fee
- Theatre or procedure-room and facility fees
- The single-use balloon device
- Pre-procedure CT scanning of the sinuses
- Any use of X-ray (fluoroscopy) guidance
- Follow-up appointments and ongoing medical treatment
- The surgeon's fee and how many sinuses it covers
- Anaesthetist's fee and the type of anaesthetic, if relevant
- Theatre/procedure-room and facility charges
- Whether the balloon device and any CT scan are included
- Number of follow-up appointments included
- Cancellation policy
- What happens, and who pays, if the balloon does not work or fuller surgery is needed
On the NHS? Balloon sinuplasty is available in some NHS services for selected chronic sinusitis without polyps; availability varies by area, private care is used for choice or speed, and medical treatment is available without any procedure.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being offered a balloon when the real problem is polyps or extensive disease needing fuller surgery.
- Overstating how long the benefit will last.
- Not explaining that it does not cure the underlying inflammation.
- No clear explanation of the rare eye and skull-base risks.
- No written emergency instructions for eye symptoms, severe headache or fluid leak.
Marketing red flags
- Promoting balloon sinuplasty as a cure-all 'quick fix' for all sinus problems.
- Recommending it for nasal polyps or extensive disease where it is not appropriate.
- Promising lasting results the evidence does not support.
- Describing it as completely without risks.
- Pushing the procedure without a CT scan or a proper trial of medical treatment.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Why are you recommending a balloon rather than fuller surgery or continued medical treatment?
- Does my sinus problem genuinely suit balloon dilation, given whether I have polyps?
- What improvement is realistic for me, and how long is it likely to last?
- What happens if the balloon does not work or my symptoms return?
- Will it be done under local anaesthetic, sedation or general anaesthetic?
- What ongoing sprays or rinses will I need afterwards?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
How is balloon sinuplasty different from traditional sinus surgery?
Is balloon sinuplasty right for me?
Will the benefit last?
Does it hurt, and is there a scar?
Is it available on the NHS?
What does NICE say about it?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE — Balloon catheter dilation of paranasal sinus ostia (IPG273) NICE HTG174 — Relieving chronic sinusitis using an inflatable balloon ENT UK — Balloon sinuplasty Current indications for balloon sinuplasty — PubMed NICE CKS — Chronic rhinosinusitis
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Functional endoscopic sinus surgery (FESS) · Nasal polyp removal · Septoplasty (deviated septum) · Nosebleed cautery · Turbinate reduction